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Cardiac imaging and non-invasive testing
Left ventricular function and energy metabolism in middle-aged men undergoing long-lasting sustained aerobic oxidative training
  1. G Perseghin1,2,3,6,
  2. F De Cobelli2,4,
  3. A Esposito4,
  4. E Belloni4,
  5. G Lattuada1,
  6. T Canu4,
  7. P L Invernizzi3,
  8. F Ragogna1,
  9. A La Torre3,
  10. P Scifo2,5,
  11. G Alberti3,6,
  12. A Del Maschio2,4,7,
  13. L Luzi1,2,3,6
  1. 1
    Internal Medicine-Section of Nutrition/Metabolism, IRCCS H San Raffaele, Milan Italy
  2. 2
    Unit of Clinical Spectroscopy, IRCCS H San Raffaele, Milan Italy
  3. 3
    Faculty of Exercise Sciences, Università degli Studi di Milano, Milan Italy
  4. 4
    Division of Diagnostic Radiology, IRCCS H San Raffaele, Milan Italy
  5. 5
    Division of Nuclear Medicine, IRCCS H San Raffaele, Milan Italy
  6. 6
    Center “Physical exercise for health and wellness”, Milan Italy
  7. 7
    Università Vita e Salute San Raffaele, Milan Italy
  1. Professor Gianluca Perseghin, Faculty of Exercise Sciences, Università degli Studi di Milano and Internal Medicine Istituto Scientifico San Raffaele, via Olgettina 60, 20132, Milan Italy; perseghin.gianluca{at}


Objective: Ageing of the human heart is characterised by morphological, functional and metabolic changes. Short-term interventions and cross-sectional studies in older individuals questioned the possibility that physical exercise may reverse these alterations. In this study we aimed to assess whether in middle-aged men involved in regular and long lasting physical activity these alterations were attenuated.

Design: Left ventricular (LV) magnetic resonance imaging (MRI) and three-dimensional image selected in-vivo spectroscopy (3D-ISIS) 31P magnetic resonance spectroscopy (MRS) were performed using a 1.5T scanner in 20 healthy, young and 25 healthy middle-aged non-obese men with a sedentary lifestyle (11 young and 14 middle-aged) or undergoing regular aerobic oxidative training (9 young and 11 middle-aged). Insulin sensitivity was estimated by the homeostatic model assessment 2 (HOMA-2) model.

Results: Sedentary young and middle-aged men were not different with respect to LV morphological parameters and systolic function. The phosphocreatine/ATP (PCr/ATP) ratio (marker of high energy phosphates metabolism) and the LV E-peak filling rate/A-peak filling rate ratio (E/A ratio) were lower in sedentary middle-aged than physically active subjects. Parameters of LV systolic function and the PCr/ATP ratio were not different in the middle-aged compared with the young trained men; the E/A peak flow ratio was higher in the middle-aged trained men than in the middle-aged sedentary men. Within the entire population, the PCr/ATP ratio and the E/A peak flow ratio were associated with insulin sensitivity.

Conclusions: Trained middle-aged subjects showed a better pattern of LV energy metabolism and of diastolic function than their sedentary counterparts. At this age the exercise-related cardiac benefits were detectable when physical exercise was performed regularly and for a long period of time.

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  • Funding: This study was supported by grants from the Italian Ministry of Health (RF98.49, RF99.55, RF01.1831) and by a grant by the European Association for the Study of Diabetes (EFSD).

  • Competing interests: None.

  • Ethics approval: The protocol was approved by the ethics committee of the Istituto Scientifico H San Raffaele.